Point-of-care Ultrasound Is Useful In Pneumonia

I had pneumonia over the holidays.  So did my son.  The doctor wanted a chest x-ray, and I said I will ultrasound my chest when I get back to the office.  I am now at the office, and I picked up a little fluid in my lateral posterior chest cavity consistent with the pain I experienced over the last few days.  We are both on antibiotics, and I will monitor the fluid collection with ultrasound rather than a chest x-ray.  Saves time, money and x-rays.  BTW, I feel much better now.  Here's an article about ultrasound and pneumonia.



Point-of-care ultrasound is more accurate than the traditional method of auscultation by stethoscope in diagnosing pneumonia in children and young adults, and can even detect small pneumonias that a chest x-ray may miss, a Mount Sinai researcher reports in an article titled, "Prospective Evaluation of Point-of-Care Ultrasonography for the Diagnosis of Pneumonia in Children and Young Adults" in the online edition of Archives of Pediatrics & Adolescent Medicine published December 10, 2012.
These findings have important public health implications, especially in the developing world, as pneumonia is the leading cause of death in children worldwide. Pneumonia kills an estimated 1.2 million children under the age of five years every year – more than AIDS, malaria and tuberculosis combined.
"The World Health Organization has estimated as many as three-quarters of the world's population, especially in the developing world, does not have access to any diagnostic imaging, such as chest x-ray, to detect pneumonia," said senior author James Tsung, MD, MPH, Associate Professor of Emergency Medicine and Pediatrics at Mount Sinai School of Medicine. "Many children treated with antibiotics may only have a viral infection-- not pneumonia. Portable ultrasound machines can provide a more accurate diagnosis of pneumonia than a stethoscope."

http://www.eurekalert.org/pub_releases/2012-12/tmsh-pui120712.php

Wives Are Great When Men Are Sick

Update.  My wife hauled the whole family to the clinic where she is a nurse.  She is getting the prescriptions filled while I try to drink water.  Our whole family was hit by a bug.  We are not sure if it is viral or bacteria.  I am not feeling like Tarzan, but I can tell you my right sided lung pain will be dealt with using ultrasound in the morning if I make it to my office.  We will all have lack of appetite, and have smelly urine for a few days due to antibiotics and an expectorant.  I will spend a few hours thanking God for my family.  The picture is from one of my collections.  Anyone guess where?   Be at Peace.  Gizz

Merry Christmas to Sonographers

Merry Christmas all.  I  am sorry for not posting for a bit.  My whole family was hit by a nasty virus over the last few days leading up to the birth of Christ.  I got a lung infection (bacterial pneumonia ) that had to send us about the house looking for a round of antibiotics.  I spat up blood and the wife said you are sick.  I am still having wild dreams and sleeping most day and night.  Thank yourselves for a great spouse whoever you are if you are married with family.  Trust friends if you are single.  And thank God for being here.  I will return.

Pulmonary Ultrasound: New Territory

I am excited about a new technique involving ultrasound and the lungs.  I did some research after meeting a student of mine who is a lung doctor here in Houston.  It seems we are now able to identify, evaluate and biopsy the lymph nodes near the Carina.  Techniques and procedures have been invented to stage patients with lung and mediastinal cancers using ultrasound techniques.  These procedures involve ultrasound bronchoscopy.  I am researching companies who provide the equipment for these procedures.  This article I am posting is the first for me, and truly cutting edge.

Here is an article I picked up on the google creature.

For many years the lung has been considered off-limits for ultrasound. However, it has been recently shown that lung ultrasound (LUS) may represent a useful tool for the evaluation of many pulmonary conditions in cardiovascular disease. The main application of LUS for the cardiologist is the assessment of B-lines. B-lines are reverberation artifacts, originating from water-thickened pulmonary interlobular septa. Multiple B-lines are present in pulmonary congestion, and may help in the detection, semiquantification and monitoring of extravascular lung water, in the differential diagnosis of dyspnea, and in the prognostic stratification of chronic heart failure and acute coronary syndromes. 

Thanks Cardiovascular Ultrasound

 http://www.cardiovascularultrasound.com/content/9/1/6

Point Of Care Ultrasound and Radiologists

Radiologists are experts at interpreting ultrasound and have been on the cutting edge of everything dealing with medical imaging for many years.  Point of care ultrasound is a relatively new variety of ultrasound and is seen as a first response form of diagnostic imaging.  Interest is growing among first responders such as paramedics in point of care ultrasound now that the equipment is portable.  The company I work for has been teaching point of care ultrasound now for going on three years.



“Radiologists are not involved in ultrasound education and promoting its use in point of care or elsewhere, but it would be nice to have more involvement,” Michael Blaivas, MD, an emergency medicine physician and past chair of the American College of Emergency Physicians ultrasound section, said during a presentation at RSNA 2012 this week. “It’s better to be seen as proponents of an application, guide it, and help with it, especially an application that is seen as critical at the bedside.”
Radiologists are the ultrasound imaging experts, Blaivas said, and should be the first to share their expertise. The specialties shouldn’t be fighting each other, he said, but working to make sure the modality thrives for all clinicians. If radiologists were more involved in teaching, they could ensure quality in its use.
“There really is a need for ultrasound education, and this is somewhere we can meet,” he said.

Thanks "Diagnostic Imaging"

http://www.diagnosticimaging.com/conference-reports/rsna2012/content/article/113619/2117117

Sudden Cardiac Death And Athletes

I came across an article in New Scientist about sudden cardiac death (SCD) and athletes.  The article addressed the cost of screening athletes for cardiac abnormalities which could cause them to have a fatal heart attack while playing sports.  We echocardiographers are familiar with at least one family of diseases which affect the heart in this manner.  Collectively known as hypertrophic cardiomyopathies, they are difficult to screen for with routine EKG.  It is definitively identified by an echocardiogram, or cardiac MRI.  I have personally been part of a team of health care professionals charged with screening entire junior high schools for this disease.  I believe a focused limited echocardiogram should be part of a pre-athletic physical for all students entering junior high.  I also believe that the cost of this limited echocardiogram can be manageable if civic group, schools and other organizations raise money to deffer the costs associated with this wonderful screening tool.  There have been attempts in the recent past to organize these screening events with limited success.  The benefits seem to outweigh the costs.

"When it comes to professional footballers, problems of the heart are often to do with their latest tryst. But lately, they have taken a much more serious nature.

Last week, 27-year-old Mitchell Cole died of heart disease, a year after he was forced to retire from professional soccer in the UK because of a known heart condition. This follows a report last week that another British footballer, Radwan Hamed, who was only 17 when he had a heart attack on the pitch, will be suing his former club, Tottenham Hotspur, over the brain damage that he suffered as a result."

Thanks New Scientist

http://www.newscientist.com/article/dn22568-screening-athletes-for-heart-problems-much-too-pricey.html

Spinach Is Safer Thanks To Ultrasound

Excellent!  Spinach is now safer than ever to eat thanks to ultrasound sterilization.  A few years back spinach got a bad rap because a batch got contaminated with some bacteria and made many people sick.  New ultrasound technology allows farmers to better eliminate bacteria and other pathogens by using ultrasound energy to destroy these bugs without harming the spinach.  I am a spinach lover, and glad for this because I especially love fresh spinach salads.  Here is my recipe for a fresh bag of cooked spinach:



1 bag of fresh spinach
balsamic vinegar
butter
black pepper
MAGGI liquid seasoning

Wash the bagged spinach (Even though it says it is already washed) then pat dry.  Melt 2 tablespoons of butter in a pot and dump the whole spinach in and cook over low-medium heat about 5 minutes and stir.  Add MAGGI to taste, then 2 tablespoons of balsamic vinegar. black pepper to taste.  Enjoy!

"By combining continuous ultrasound treatment with chlorine washing, we can reduce the total number of food-borne pathogenic bacteria by over 99.99 percent," said Hao Feng,professor of food science and human nutrition."

Here is the link.  Thanks Sonoworld 

http://phys.org/news/2012-11-safer-spinach-scientist-technique-coli.html

Safer spinach? Scientist's technique dramatically reduces E. coli numbers November 27, 2012 University of Illinois scientists have found a way to boost current industry capabilities when it comes to reducing the number of E. coli 0157:H7 cells that may live undetected on spinach leaves.

Read more at: http://phys.org/news/2012-11-safer-spinach-scientist-technique-coli.html#jCp

According to Feng, the USDA is looking for proposed technologies that can achieve a 4 to 6 log reduction in pathogen cells (a 6 log reduction would achieve a million-fold reduction in pathogenic bacteria). The food processing industry can now achieve a 1 log or tenfold reduction. In comparison, the U of I technique yields a 4 log reduction. "Combining technologies is the key to bridging the gap between our current capacity and what USDA would like to see. The use of ultrasound exposure during chlorine washing gives the industry a way to significantly enhance microbial safety," he said.

Read more at: http://phys.org/news/2012-11-safer-spinach-scientist-technique-coli.html#jCp

"By combining continuous ultrasound treatment with chlorine washing, we can reduce the total number of foodborne pathogenic bacteria by over 99.99 percent," said Hao Feng, a U of I professor of food science and human nutrition. According to Feng, the USDA is looking for proposed technologies that can achieve a 4 to 6 log reduction in pathogen cells (a 6 log reduction would achieve a million-fold reduction in pathogenic bacteria). The food processing industry can now achieve a 1 log or tenfold reduction. In comparison, the U of I technique yields a 4 log reduction. "Combining technologies is the key to bridging the gap between our current capacity and what USDA would like to see. The use of ultrasound exposure during chlorine washing gives the industry a way to significantly enhance microbial safety," he said.

Read more at: http://phys.org/news/2012-11-safer-spinach-scientist-technique-coli.html#jCp